DR. JUSTIN FOWLER MD
NPI 1386835585
Surgery - Surgical Critical Care in Boise, ID

Q: What is Justin Fowler's NPI number?

The NPI number for Justin Fowler is 1386835585. It was assigned to this individual provider in the NPPES registry on August 5, 2007.

Q: What is Justin Fowler's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Q: When was this NPI record last updated?

The NPPES record for Justin Fowler was last updated on December 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 05, 2007PECOS EnrolledAccepts Medicare Assignment

6165 W EMERALD ST, BOISE, ID 83704(208) 302-3900(208) 302-3955 Get Directions Write a Review

NPPES record last updated: December 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 16, 2024, Sep 26, 2024, Sep 12, 2024 and 4 more (7 updates tracked since 2018).

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About Dr. Justin Fowler Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUSTIN FOWLER MD (NPI 1386835585) is an individual surgical critical care provider in Boise, Idaho, licensed in Idaho (M-13069) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1386835585

Entity TypeIndividualMale

Primary Taxonomy2086S0102X

Provider Legal NameDR. JUSTIN FOWLERCredential: MD

Location Address6165 W EMERALD STBoise, ID 83704-8613

Mailing Address3551 Roger Brooke DrFort Sam Houston, TX 78234-4504 · (210) 916-3174

Phone(208) 302-3900

Fax(208) 302-3955

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 2007

Enumeration DateAugust 5, 2007

Last NPPES UpdateDecember 16, 20247 updates tracked since enumeration

NPPES CertifiedDecember 16, 2024

✔ NPI 1386835585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians

Taxonomy Code2086S0102X

License✔ Licensed in ID · M-13069

Definition

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedMilitary Health Care ProviderTaxonomy 171000000X

Also ListedOrthopaedic Surgery · Orthopaedic TraumaTaxonomy 207XX0801X · License M-13069 (ID), MD2014-0304 (NM), 2016027259 (MO), Q6009 (TX)

6165 W EMERALD ST, Boise, ID 83704

Open in Google Maps ↗

Secondary Practice Locations 5

Location 15005 N Piedras StEl Paso, TX 79920-5001 · Phone (915) 569-2288 · Fax (915) 569-1919

Location 22606 Hospital Blvd Ste ECorpus Christi, TX 78405 · Phone (361) 902-4766 · Fax (361) 902-6571

Location 3613 Elizabeth St Ste 804Corpus Christi, TX 78404-2231 · Phone (361) 217-6264

Location 43551 Roger Brooke DrFort Sam Houston, TX 78234-4504 · Phone (210) 539-9582

Location 56565 E Carondelet Dr Ste 235Tucson, AZ 85710-3533 · Phone (520) 367-1050

Other Identifiers 4

Other2016027259MO · Mo License

Other1L5640TX · Medicare

OtherP02601779TX · Mcrr

Medicaid390382503TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Avera Health Plans, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Justin Fowler Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971746058

PECOS Enrollment IDI20191114003338, I20240614001869

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130002

Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE Q ANDERSON NP

Nurse Practitioner